Trial reportThorax2005
Comparison between pathogen directed antibiotic treatment and empirical broad spectrum antibiotic treatment in patients with community acquired pneumonia: a prospective randomised study.
Trial report in Thorax, 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04651712 (The Effect of a Point-of-care Sputum Specimen Assay on Antibiotic Treatment of Patients Admitted Acutely With Suspected Pneumonia), which is not on this map. Cited by 60 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Effect of a Point-of-care Sputum Specimen Assay on Antibiotic Treatment of Patients Admitted Acutely With Suspected Pneumonia: A Multicenter Randomized Controlled Trial
Who cites it
60 citing papers in PubMed, 6 syntheses or guidelines pooled it, 193 citations in OpenAlex.
- Therapeutical strategies in cavitary legionnaires' disease, two cases from the field and a systematic review.Annals of clinical microbiology and antimicrobials · 2023Pooled it
- Sputum Gram Stain for Bacterial Pathogen Diagnosis in Community-acquired Pneumonia: A Systematic Review and Bayesian Meta-analysis of Diagnostic Accuracy and Yield.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020Pooled it
- Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America.American journal of respiratory and critical care medicine · 2019Guideline
- Usefulness of sputum gram stain for etiologic diagnosis in community-acquired pneumonia: a systematic review and meta-analysis.BMC infectious diseases · 2019Pooled it
- Systematic review and meta-analysis of a urine-based pneumococcal antigen test for diagnosis of community-acquired pneumonia caused by Streptococcus pneumoniae.Journal of clinical microbiology · 2013Pooled it
- Infectious Diseases Society of America/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2007Guideline
- Trial
- A Phase 2 study of the novel fluoroquinolone JNJ-Q2 in community-acquired bacterial pneumonia.The Journal of antimicrobial chemotherapy · 2013Trial
- Impact of pneumococcal urinary antigen testing on clinical outcomes in patients hospitalized with community-acquired pneumonia.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025Article
- Hospitalization due to pneumonia in Australia, England, and Wales: An ecological cross-sectional study.Medicine · 2025Article
- Multiplex PCR Pneumonia Panel in Critically Ill Patients Did Not Modify Mortality: A Cohort Study.Antibiotics (Basel, Switzerland) · 2025Article
- The Adequacy of Current Legionnaires' Disease Diagnostic Practices in Capturing the Epidemiology of Clinically RelevantPathogens (Basel, Switzerland) · 2024Article
- Guidelines for Antibiotics Prescription in Critically Ill Patients.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2024Article
- Guideline-Concordant Therapy for Community-Acquired Pneumonia in the Hospitalized Population: A Systematic Review and Meta-analysis.Open forum infectious diseases · 2024Article
- Practicing Medicine Wisely: Routine Use of Urine Legionella in Suspicious Pneumonia - Are we Overdoing?JNMA; journal of the Nepal Medical Association · 2024Article
- Optimizing Diagnosis and Management of Community-acquired Pneumonia in the Emergency Department.Emergency medicine clinics of North America · 2024Review
- Article
- Diagnosis and Therapy of Community-Acquired Pneumonia in the Emergency Department: A Retrospective Observational Study and Medical Audit.Journal of clinical medicine · 2024Article
- Metagenomic sequencing of post-mortem tissue samples for the identification of pathogens associated with neonatal deaths.Nature communications · 2023Article
- Q Fever as a Cause of Community-Acquired Pneumonia in French Guiana.The American journal of tropical medicine and hygiene · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere is much controversy about the ideal approach to the management of community acquired pneumonia (CAP). Recommendations differ from a pathogen directed approach to an empirical strategy with broad spectrum antibiotics.
methodsIn a prospective randomised open study performed between 1998 and 2000, a pathogen directed treatment (PDT) approach was compared with an empirical broad spectrum antibiotic treatment (EAT) strategy according to the ATS guidelines of 1993 in 262 hospitalised patients with CAP. Clinical efficacy was primarily determined by the length of hospital stay (LOS). Secondary outcome parameters for clinical efficacy were assessment of therapeutic failure on antibiotics, 30 day mortality, duration of antibiotic treatment, resolution of fever, side effects, and quality of life.
resultsThree hundred and three patients were enrolled in the study; 41 were excluded, leaving 262 with results available for analysis. No significant differences were found between the two treatment groups in LOS, 30 day mortality, clinical failure, or resolution of fever. Side effects, although they did not have a significant influence on the outcome parameters, occurred more frequently in patients in the EAT group than in those in the PDT group (60% v 17%, 95% CI -0.5 to -0.3; p<0.001).
conclusionsAn EAT strategy with broad spectrum antibiotics for the management of hospitalised patients with CAP has comparable clinical efficacy to a PDT approach.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.